The Journal of heart transplantation最新文献_第5页

Factors influencing the development of hypertension after heart transplantation. 心脏移植术后高血压发生的影响因素。

The Journal of heart transplantation Pub Date : 1990-09-01

E Ozdogan, N Banner, M Fitzgerald, F Musumeci, A Khaghani, M Yacoub

{"title":"Factors influencing the development of hypertension after heart transplantation.","authors":"E Ozdogan, N Banner, M Fitzgerald, F Musumeci, A Khaghani, M Yacoub","doi":"","DOIUrl":"","url":null,"abstract":"In this study we investigated the factors influencing the development of hypertension in 488 consecutive heart transplant recipients. The cumulative probability of hypertension (blood pressure persistently above 150/95 mm Hg) developing was 52% at 1 year, 67% at 2 years, 73% at 3 years, and 77% at 4 years after transplantation. The incidence was higher in patients receiving cyclosporine and azathioprine compared with those receiving prednisone and azathioprine immunosuppression. The dose of cyclosporine used did not appear to influence the development of hypertension. Intermittent steroid exposure did not increase the incidence in the cyclosporine group. Male transplant recipients and those older than 20 years appeared more prone to the development of hypertension. A family history of cardiovascular disease also increased the incidence. Preoperative and postoperative kidney dysfunction and transplantation because of ischemic heart disease did not appear to affect the incidence of hypertension. Donor characteristics, including the use of hearts from donors who weighed more than the recipients and from patients dying of spontaneous intracranial hemorrhage, did not appear to increase the incidence of hypertension after heart transplantation.","PeriodicalId":77638,"journal":{"name":"The Journal of heart transplantation","volume":"9 5","pages":"548-53"},"PeriodicalIF":0.0,"publicationDate":"1990-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13382872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Regeneration of adult human myocardium after acute heart transplant rejection. 成人心脏移植急性排斥反应后心肌的再生。

The Journal of heart transplantation Pub Date : 1990-09-01

J T McMahon, N B Ratliff

{"title":"Regeneration of adult human myocardium after acute heart transplant rejection.","authors":"J T McMahon, N B Ratliff","doi":"","DOIUrl":"","url":null,"abstract":"From August 1984 to March 1989, 1535 endomyocardial biopsy specimens from 79 heart transplant patients were evaluated for rejection. Electron microscopy was performed on 664 of these specimens. Three hundred eighty-eight were diagnosed as accelerating, moderate, severe, or resolving acute rejection. Regeneration of adult human myocardium after acute rejection was seen in 22 specimens. Regeneration was identified in myocytes showing ultrastructural and light microscopic evidence of nuclear division and cytoplasmic dedifferentiation. Regenerating cell nuclei showed complex surface involution and large nucleoli. Cytoplasm appeared embryonic with abundant ribosomes, rough endoplasmic reticulum, and numerous mitochondria. Sarcomerogenesis was associated with cytoplasmic and subsarcolemmal clumps of Z band material. Myofibrillogenesis occurred throughout the cytoplasm but was favored in subsarcolemmal areas. Intercalated discs were primitive and depended on the differentiation state of adjoining myocytes. Nexus junctions were not seen. We conclude that myocyte injury during acute rejection of heart transplants is reversible and that adult human myocytes have a hitherto unsuspected capacity for regeneration.","PeriodicalId":77638,"journal":{"name":"The Journal of heart transplantation","volume":"9 5","pages":"554-67"},"PeriodicalIF":0.0,"publicationDate":"1990-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13382873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combined Registry for the Clinical Use of Mechanical Ventricular Assist Pumps and the Total Artificial Heart in conjunction with heart transplantation: fourth official report--1989. 机械心室辅助泵和全人工心脏联合心脏移植临床应用联合登记:第四次官方报告——1989年。

The Journal of heart transplantation Pub Date : 1990-09-01

C A Miller, W E Pae, W S Pierce

引用次数: 0

Bridge to heart transplantation: importance of patient selection. 心脏移植的桥梁:患者选择的重要性。

The Journal of heart transplantation Pub Date : 1990-09-01

J E Reedy, M T Swartz, D F Termuhlen, D G Pennington, L R McBride, L W Miller, S A Ruzevich

{"title":"Bridge to heart transplantation: importance of patient selection.","authors":"J E Reedy, M T Swartz, D F Termuhlen, D G Pennington, L R McBride, L W Miller, S A Ruzevich","doi":"","DOIUrl":"","url":null,"abstract":"Since 1986, 26 candidates were evaluated for mechanical support as a bridge to heart transplantation. Group 1 consisted of 15 patients who were accepted and who received support with a ventricular assist device (14 patients) or a total artificial heart (1 patient). Seven of the 15 patients received transplants and survived, whereas contraindications to transplant developed in seven patients while they were receiving support, and these seven died. One patient remains hospitalized after transplantation. Group 2 consisted of 11 patients rejected for circulatory support because of renal insufficiency or infection (9), pulmonary embolus (1), and cerebrovascular accident (1). Two group 2 patients underwent transplant procedures after their complications resolved, and one survived. One other group 2 patient who recovered without transplantation or mechanical support was discharged. There was no significant difference in age, gender, or cause of cardiogenic shock between the two groups. Four of five patients accepted for mechanical support on the first evaluation survived, and three of 10 accepted after the initial evaluation survived, indicating that delayed selection often results in complications that preclude transplantation and survival. Only one of the 26 patients survived without transplantation or support. These data emphasize the importance of patient selection on the outcome of bridging to transplantation.","PeriodicalId":77638,"journal":{"name":"The Journal of heart transplantation","volume":"9 5","pages":"473-80; discussion 480-1"},"PeriodicalIF":0.0,"publicationDate":"1990-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13382330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Kinking of the pulmonary artery: a treatable cause of acute right ventricular failure after heart transplantation. 肺动脉扭结:心脏移植后急性右心室衰竭的可治疗原因。

The Journal of heart transplantation Pub Date : 1990-09-01

G Dreyfus, V A Jebara, J P Couetil, A Carpentier

引用次数: 0

Quality of life after heart transplantation in patients assigned to double- or triple-drug therapy. 心脏移植后双药或三联治疗患者的生活质量。

The Journal of heart transplantation Pub Date : 1990-07-01

B M Jones, F J Taylor, O M Wright, A Harvison, M McBride, P M Spratt, V P Chang

引用次数: 0

Thoratec VAD system as a bridge to heart transplantation. Thoratec VAD系统作为心脏移植的桥梁。

The Journal of heart transplantation Pub Date : 1990-07-01

D J Farrar, J H Lawson, P Litwak, G Cederwall

{"title":"Thoratec VAD system as a bridge to heart transplantation.","authors":"D J Farrar, J H Lawson, P Litwak, G Cederwall","doi":"","DOIUrl":"","url":null,"abstract":"As of October 1988 the Thoratec ventricular assist device system was used in 72 heart transplant candidates at 20 medical centers in five countries. All patients were in imminent risk of dying before donor heart procurement, with a mean cardiac index of 1.6 +/- 0.5 L/min/m2 and a pulmonary capillary wedge pressure of 27 +/- 8 mm Hg, in spite of maximal medical therapy. The ventricular assist device system consists of a prosthetic ventricle (Pierce-Donachy design) with a 65 ml pumping chamber, made of Thoratec's BPS-215M polyurethane, appropriate cannulae for atrial or ventricular inflow and for arterial outflow connections, and a pneumatic drive console. The devices can be used for partial or complete support of the pulmonary and systemic circulations. Fifty-eight (81%) of the 72 patients received biventricular devices and 14 received support only on the left side of the heart. Average flow rate was 5.0 +/- 0.7 L/min on the left side and 4.3 +/- 0.7 on the right. Fifty-four patients (75%) recovered sufficiently to undergo heart transplantation after a median of 4.4 days (mean, 14.3 days; range, 8 hours to 81 days), and 45 of them have been discharged from the hospital (83% early posttransplant survival and 63% overall survival from implant to discharge). Of 14 patients supported for more than 30 days, 11 underwent heart transplantation, and nine were discharged alive. The actuarial 1- and 2-year posttransplant survival rates are 78% and 75%. We conclude that these heterotopic prosthetic devices provide an effective method of maintaining blood flow to vital organs until a donor heart can be procured.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":77638,"journal":{"name":"The Journal of heart transplantation","volume":"9 4","pages":"415-22; discussion 422-3"},"PeriodicalIF":0.0,"publicationDate":"1990-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13548214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of cold flush perfusion with modified blood versus modified Euro-Collins solution for lung preservation. 改良血冷冲灌注与改良Euro-Collins液肺保存的比较。

The Journal of heart transplantation Pub Date : 1990-07-01

T L Hooper, T J Locke, G Fetherston, P A Flecknell, C G McGregor

{"title":"Comparison of cold flush perfusion with modified blood versus modified Euro-Collins solution for lung preservation.","authors":"T L Hooper, T J Locke, G Fetherston, P A Flecknell, C G McGregor","doi":"","DOIUrl":"","url":null,"abstract":"Single flush perfusion of the lung represents one concept of pulmonary preservation that has provided satisfactory results in both experimental and clinical situations. The technique has allowed successful distant organ procurement, with consequent enlargement of the available donor pool. Both cold modified blood (CMB) and modified Euro-Collins solution (ECS) are currently used as perfusates, although the volumes of each used clinically are different. CMB is administered at 20 ml/kg and ECS at 60 ml/kg. Both techniques combine the use of a prostaglandin to enhance preservation. In this study these two perfusion techniques were compared in a canine model of unilateral left lung allotransplantation after 6 hours of storage, with subsequent ligation of the recipient's contralateral pulmonary artery and bronchus. Equal volumes of both solutions were used (20 ml/kg) to determine whether the blood vehicle was necessary to provide good preservation at this volume. Assessment of pulmonary preservation was determined by animal survival, blood gas analyses, hemodynamic values, and measurement of lung water content. All animals survived the 24-hour experimental period in stable condition. Postoperative oxygenation was well maintained at control values throughout this period with no significant difference between groups. The pulmonary vascular resistance index was significantly higher in the CMB group at 1 hour (p less than 0.05). Lung compliance, assessed by peak-inspiratory pressure, was impaired to a greater extent in the CMB group than in the ECS animals (p less than 0.01 at 12 and 24 hours).(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":77638,"journal":{"name":"The Journal of heart transplantation","volume":"9 4","pages":"429-34"},"PeriodicalIF":0.0,"publicationDate":"1990-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13548219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implantation of an external biventricular assist device: role of transesophageal two-dimensional echocardiography. 外置双心室辅助装置的植入:经食管二维超声心动图的作用。

The Journal of heart transplantation Pub Date : 1990-07-01

G Faggian, M Dan, U Bortolotti, U Livi, G Stellin, C Sorbara, A Mazzucco, V Gallucci

引用次数: 0

Sexual concerns after heart transplantation. 心脏移植后的性问题。

The Journal of heart transplantation Pub Date : 1990-07-01

J B Tabler, R L Frierson

引用次数: 0